It all begins with..., one day you're walking at home or work and then your leg
gives out and you fall. You may have these strange spots in your eyes that never
seem to go away even when you clean your glasses. Your arm feels like it has
fallen asleep again, or you seem to be tired all of the time and can't get your
energy back. It could be that your speech is slurred and you haven't had
anything to drink in a week or two, or it's the middle of summer and you thought
you were going to get that yard work done, instead you feel wiped out and have
to rest. Then your arms and hands shake or tremor uncontrollably, or one of
another hundred things could be happening. It's time for you to go see a doctor.

Then you see a doctor, and then a neurologist, and have some wonderful tests
done to rule out some conditions and then to verify one. A magnetic resonance
imaging (MRI) will reveal if there is any scarring and then a lumbar puncture or
spinal tap will provide you with confirmation. You are then presented with
multiple sclerosis (MS) and it's the answer, the reason, and the cause. What is
this horrible thing and what's it doing to you? What will become of you and your
future? Where will this thing take you and how bad will it get?

The two MRI's below show lesions on the brain and on the spinal cord. There are
three distinct lesions on the left image of the brain and three distinct lesions
on the spinal cord around the 2nd and 3rd cervical vertebra. There is a great
significance to the lesions on the spinal cord in that the location is prior to
any branching off. Lesions at this location can have a profound impact on
multiple locations and possibly with greater severity. This could be compared to
damage on a high voltage electrical wire and when it has problems, all of the
smaller wires have problems.

How does MS progress or worsen? What are the stages of this disease? Where are
you in all this? The type of MS or its clinical course is of great importance.

Each type is a worsening of the disease and when it reaches the next course,
there is no turning back. That's why early detection and diagnosis is so
important. When a doctor suspects that the symptoms could possibly be MS, they
try to rule out anything else but it can only confirmed through an MRI and
spinal tap. An MRI of the brain and spinal cord will show any lesions or scars
existing or in an active state. A spinal tap will give them further confirmation
of the disease when the spinal fluid is tested. Now they can proceed to the next
step.

Enlarge by passing over or clicking

Prior to the mid-1990's, when someone was diagnosed with MS, it was generally
felt that there was not much that could be done to keep it at bay. Once the
current medications were approved and the results looked so good, doctors began
to place patients on the medications as soon as they were diagnosed. As with any
illness, early treatment is the key to slowing down the progression.
Unfortunately, slowing it down is the best option at the current time. Every
step, with every drug, brings us that much closer to a time when MS can be
stopped, reversed, or even cured.

Since MS is a chronic disease, progression will most likely occur. On the bright
side, around 80% of those with MS have relapsing-remitting MS (RRMS). You can
also have progression while staying within your current clinical course. When
progression increases in frequency, duration, severity, etc..., your clinical
course may change.

You can have an impact on how strong or rapid your progression is by just
remembering all those bits of advise from your doctors and even your parents -
exercise daily, proper nutrition, don't stay up too late, get plenty of sleep,
and the list goes on and on. It all boils down to taking care of yourself, your
body and your mind. The other benefit of this bit of advice would possibly be a
lowering of your cholesterol, a healthier heart, greater strength, and possibly
an improvement of your symptoms.

Each of the four clinical courses can range from mild, moderate, or severe. It's
all, however, just a degree of the same thing, you have MS. It's kind of like
being pregnant, either you are or you aren't, how far along is the only
variable.

Now either you have MS and you must take it very seriously or you don't. Just
because you might have a mild case of RRMS doesn't mean that you don't have to
treat it. No matter which severity of the clinical courses you may have, they
all must be taken very seriously, for if you don't, it may just cost you a price
that is more than you wish to pay.

It's important to know that you can no longer afford to burn the candle at both
ends. It's important that you make that candle last as long as you can, because
it's your only one and can't be replaced. You don't have to stop what you do,
but rather become careful with your choices and mindful of the consequences.
Just like when you are in your 40's or 50's, you can't act as if you are 18
again, whether or not you have MS. You can, however, still have a good time and
enjoy life.

Three not so common courses of MS

●

Chronic-Progressive MS (CPMS)

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Malignant MS

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Benign MS

Chronic-progressive MS (CPMS) and malignant MS both are not welcome. They both
are running a course that is leading to greater and nearly constant attacks. You
aren't given much if any rest between the battles upon yourself. These, however,
aren't very common, but one person with one of these is too many. These two
would usually fall in the severe progressive-relapsing MS (PRMS) clinical course
from above.

Now what anyone with MS would hope for, other than a cure, would be to have
benign MS since it gives you a glimpse of its strength and the chance to take it
seriously. This usually makes and appearance with an exacerbation and never
shows up again. To have one attack and possibly not to have anymore, that's
something to dream about. This would usually fall in the mild RRMS clinical
course from above.

Pediatric MS

Although MS occurs most commonly in adults, it’s also diagnosed in children and
adolescents. Estimates suggest that 8,000 to 10,000 children (those 18 years of
age or less) in the U.S. have MS, and another 10,000 to 15,000 have experienced
at least one symptom suggestive of MS.

MS historically has been viewed as an adult-onset disease and the majority of
research and support programs have targeted adults. Since 1980, however, over
400 cases of childhood MS have been recorded in over 25 medical publications.
Initial symptoms have been seen as early as 13 months old, with diagnosis as
young as 2 years of age. Largely because of new technology, the numbers of
children and adolescents diagnosed with MS are steadily growing.

Studies have shown that 2 to 5% of all people with MS have a history of symptoms
onset prior to the age 18. Diagnosis in children is more challenging than in
adults due to the frequency of other childhood disorders with similar symptoms
and characteristics. Most symptoms of MS seen in children are similar to those
seen in adults. There are, however, symptoms experienced by children that are
not typical in adults, such as seizures and mental status changes.

Increasing evidence suggests a slower disease course in children with MS, but
significant disability can accumulate at an earlier age compared to individuals
with adult onset MS. Psychosocial consequences of MS in children and adolescents
may affect academic performance, family relations, and specific adolescent
issues including self-image and relationships with peers. An evaluation by a
trained professional can help determine appropriate interventions. Pediatricians
may not be familiar with MS because they are not expecting to see it in
children.

As the leading private funder of MS research, and because of the critical need
to better understand childhood MS, the National MS Society established the
first-of-its kind network of Pediatric MS Centers of Excellence. The centers were established in
geographically diverse areas so that they can serve as regional centers for as
many children and families living with MS as possible. They are staffed by teams
of pediatric and adult MS experts who lead the field in MS diagnosis and
treatment. The Center locations are:

●

Center for Pediatric-Onset Demyelinating Disease at the Children's
Hospital of Alabama, University of Alabama at Birmingham

●

Pediatric MS Center of the Jacobs Neurological Institute, State
University of New York at Buffalo